title: Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla.
abstract: OBJECTIVE
  The purpose of this study was to assess differences in enhancement effects of liver parenchyma between normal and cirrhotic livers on dynamic, Gd-EOB-DTPA enhanced MRI at 3T.
  
  
  METHODS
  93 patients with normal (n=54) and cirrhotic liver (n=39; Child-Pugh class A, n=18; B, n=16; C, n=5) underwent contrast-enhanced MRI with liver specific contrast media at 3T. T1-weighted volume interpolated breath hold examination (VIBE) sequences with fat suppression were acquired before contrast injection, in the arterial phase (AP), in the late arterial phase (LAP), in the portal venous phase (PVP), and in the hepatobiliary phase (HBP) after 20 min. The relative enhancement (RE) of the signal intensity of the liver parenchyma was calculated for all phases.
  
  
  RESULTS
  Mean RE was significantly different among all evaluated groups in the hepatobiliary phase and with increasing severity of liver cirrhosis, a decreasing, but still significant reduction of RE could be shown. Phase depending changes of RE for each group were observed. In case of non-cirrhotic liver or Child-Pugh Score A cirrhosis mean RE showed a significant increase between AP, LAP, PVP and HBP. For Child-Pugh B+C cirrhosis RE increased until PVP, however, there was no change in case of B cirrhosis (p=0.501) and significantly reduced in case of C cirrhosis (p=0.043) during HBP.
  
  
  CONCLUSIONS
  RE of liver parenchyma is negatively affected by increased severity of liver cirrhosis, therefore diagnostic value of HBP could be limited in case of Child Pugh B+C cirrhosis.
authors.affiliation: Department of Radiology, University Hospital Regensburg, Regensburg, Germany. niklas.verloh@stud.uni-regensburg.de
authors.forename: N
authors.initials: N
authors.lastname: Verloh
authors.forename: M
authors.initials: M
authors.lastname: Haimerl
authors.forename: J
authors.initials: J
authors.lastname: Rennert
authors.forename: R
authors.initials: R
authors.lastname: Müller-Wille
authors.forename: C
authors.initials: C
authors.lastname: Nießen
authors.forename: G
authors.initials: G
authors.lastname: Kirchner
authors.forename: M N
authors.initials: MN
authors.lastname: Scherer
authors.forename: A G
authors.initials: AG
authors.lastname: Schreyer
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: C
authors.initials: C
authors.lastname: Fellner
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D000465:Algorithms; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: 3Tesla; Gd-EOB-DTPA; Liver cirrhosis; Liver function; Magnetic resonance imaging (MRI)